Resources to enhance the daily life of people living with dementia

Making yourself a cup of tea is one of those everyday tasks that signify independence. I celebrated that day my daughter was 'grown up ' enough to make me (and herself) a hot drink and I still remember how exciting it was to get a kettle in my bedroom as a teenager. Indeed one of the qualifying questions in the UK's new Personal Independence Payment government benefits assessment is the (in)ability to make your own cup of tea.

The problem?

As Dementia affects judgement and short term memory, tasks such as making a cup of tea can become overwhelming and sometimes unsafe. Overfilling the kettle, putting an electric kettle on a gas stove, not putting the kettle lid down, walking away whilst the kettle is boiling and not remembering to return and, of course the implications of lifting a heavy kettle of boiling water can be problematic.

As a well-being / activity coordinator in a residential care home I am passionate about promoting daily life skills amongst the people I work with. Our home manager had already set up a hot drinks table in the resident's lounge so that they are able to prepare their own hot drinks. However the supply of hot water has been an issue. We were using a thermos flask dispenser which keeps the water hot but is physically demanding to pump, putting it beyond the abilities of most of the residents.

A solution

A chance conversation with a friend whose son has autism and is able to make his own cups of tea has led to a revelation (and revolution!). I have been so impressed with the change that this gadget has created in our home that I felt I had to share it.

There are several manufacturers of hot water dispensers but having only roadtested one I can only review the Breville 784. The premise behind these single cup dispensers is that they only boil one cup of hot water at a time and dispense it into a waiting cup / mug with a single, easy to press button. This appeals to both energy conscious consumers and those of us looking for an easier and safer alternative to the traditional kettle.

How does it work?

The Breville has a 2 litre reservoir at the back. It opens at the top with the same sort of push button as a regular kettle. Once filled it will supply about 5 mugs of water before it needs to be refilled. You can either fill it insitu from a jug / bottle, or remove the reservoir and take it to a sink.

The hot water dispenser needs to be kept plugged in. When you want a cup of hot water you place a cup or mug under the spout and press the 'on' button on the top of the machine, a few red lights come on to signify something is happening!

Almost immediately you hear water being boiled and after a minute or two hot water is dispensed from the spout into your cup. Job done!

There is also a stop button should you change your mind, or if the cup is overflowing.

This model has a turn button to allow you to vary the amount of water dispensed. We haven't highlighted this to the older people using this machine as it seems to complicate things too much. We have set it to the correct level.

How successful has it been?

I have only bought one machine so far as I wanted to allow the residents and staff to try it first. I imagine we will get a second dispenser to minimise the refilling required. However I don't think it'll be long before I'm at the shops again as the Breville has received nothing but praise. Staff like it as it is easy and efficient. Residents have not only show their opinions with words. After just two days individuals who haven't made their own hot drink since they moved in with us are now making a cup of tea, and not only that: Mrs B proceeded to make tea for all the people in the room. I can't explain how exciting that was to see. There is some initial teaching, and ongoing reminding on how to use the machine but it is as simple as;

put a mug underneath (with tea bag or coffee granules)

press the button

wait.

I will admit to having had some concerns about safety with regards boiling water but we think nothing of handing someone a mug of boiling water in the form of a cup of tea and walking away. I will, of course, add a note of caution here. We know our residents well, along with their abilities. We will be constantly reviewing the people living with us and whether it is still a suitable option. If you are thinking about purchasing one of these machines please do so with care and after considering the person / people who will be using it. If in doubt try it under supervision.

There are plenty of other machines on the market with different capacities, some with the option to vary the amount of water dispensed, others not. This particular model is on sale at Argos at the moment.

This is a very quick post today; partly as the topic doesn't really warrant a long discussion and partly as the dog is waiting for a walk!! Today's offering is also an untested one. I plan to try using it at work this week and will report back but in the meantime I thought you might like to try it too.

I spy, as a traditional verbal game, may well be beyond the capabilities of someone with a dementia that is affecting their concentration, short term memory and language skills. However I have put together a pictoral version which should address some of those difficulties. The printable sheet I have added below doesn't have "ISpy" as a visible title as I felt this may offend an adult who might see it as a childish game. I will be refering to this as a word game which should be more acceptable.

I will be trying this game with a couple of the people I work with who have more advanced dementia but still have some verbal skills. I will be watching carefully for any signs of distress if the person really can't find the words (anomia), and I will also reiterate that pointing at the picture will do just fine, they don't need to be able to name the object out loud.

If this is successful and enjoyed I will make some more. So let me know how you get on with it and check back for more information.

One of the most common skills that seems to be lost amongst (mostly) women I work with, as their dementia progresses is knitting. This can be because of physical difficulties like arthritis but most often due to a lack of confidence of ability in this complex task. The actual knitting; putting the needle in, taking the wool around, pulling the needle through and pushing the stitch off are second nature, like a riding a bike. However following a pattern or even remembering which stitch you are knitting can be daunting and a game changer.

Bearing this in mind I was excited to come across a different way to work with wool / yarn that is straightforward. More importantly this technique can easily be shared between two people, allowing a partner to assist if it is too complex for an individual on their own; something you just can't do with traditional knitting.

Knitting looms aren't new, I can remember using a knitting doll when I was a child. This version is bigger and so easier to use for someone who finds fine motor control difficult, and the loom can be made from items that you will have in the house, or can get easily and at low cost. Once I started researching home-made looms I found lots of versions online, many made from cardboard tubes, or even a tissue box. My first trial run was with a cardboard tube and, unless you have a very thick postal tube to work with they just aren't up to the physical handling that a loom has to withstand whilst knitting. So this is my own version using a tin can.

Making a knitting loom

1. Open tin using a tin opener at both ends (even if the tin has a ring pull) so that you don't’ get sharp edges. Empty contents and carefully and thoroughly clean and dry the tin.

2. Use the Duct tape around the top and bottom edges of the tin to cover any remaining sharp edges. Only go to the next step if you are happy that the edges are not sharp and the tin is safe to use.

3. Put the two elastic bands around the tin. One by one place the lollipop sticks around the tin under the elastic bands. Space them out evenly and so that about 3cm of the stick stands above the top edge of the tin (some of the stick will also hang over the bottom edge).

4. Once you are happy that the lollipop sticks are in the right place wrap Duct tape around the tin making sure it has stuck well to both the sticks and also the tin between the sticks. Now your loom is ready!

It really is that straightforward and it should withstand a fair bit of use.

Tip:

This could easily be made as an activity itself. The lollipop sticks often seem to have small nicks and splinters along their sides so a bit of sanding paper does the trick. Some of the gentlemen I work with like doing this job as it is a familiar task and is clearly helping to work towards a specific outcome.

So now you want to know how to use it?! I have detailed instructions below and I have also added a PDF at the bottom of the page so you can print out instructions to keep with the loom. If it still isn't clear then a quick 'Google' of "knitting loom videos" will provide you with some help.

How to use the knitting loom

1. Drop the free end of the wool through the centre of the loom so that it hangs about 10cm below the bottom edge. Then wrap the wool clockwise round one of the sticks and take it around the back of that stick and the back of the stick to its right.

2. Then loop the wool clockwise around this stick; around its back, and then the back of the stick to its right.

3. Continue this around the whole loom; "behind two sticks and then loop it around, behind two sticks and then loop it around" and so on. It should then look like this:

4. Repeat for a second time around the loom.

5. If you look at the outside of the loom you will see two loops around each stick. Start 'knitting' at the first stick to the right of where you last looped over your wool. Take the bottom loop of the two and take it over the top of the loop above it and drop it over the back of the stick. Repeat this all the way around the loom moving right each time. Once you have finished that round of knitting give the yarn hanging out the bottom of the loom a little tug to pull it down a little.

6. When you have worked your way all round the loom and you are left with only single loops on each stick you need to wind the wool around again, just like you did at the beginning. i.e. "behind two sticks and then loop it around, behind two stick and then loop it around".... You might want to push the two loops down on each stick before proceeding.

7. Repeat steps 5 and 6 and you will start to see your 'knitting' coming through the bottom of the loom. Keep going until you have knitted enough.

8. To finish off stop 'knitting when you have one loop on each stick. The take one loop and move it onto the stick to its right. Loop the bottom loop over the top one. Repeat; each time you are freeing up one more stick. Continue until you have only one loop on one stick. Cut the yarn, take the loop off the final stick and pass the end of the wool through it. Pull tight to make a knot.

Tip:

If this activity needs to be simplified further the care partner can do the winding preparation for each round of the loom and then assist the person with dementia to loop the wool over. My photos show me doing the 'looping' with my fingers. It can also be done with a crochet hook. In fact I found that the easiest way to do it is to hold the loom so that the person is pulling the loop towards them, like this:

I have added a free PDF file of the instructions for using the loom so please do print them off and keep them with your loom.

If there is a pack of cards to hand then there are a multitude of games to be played. Like jokes, I can never remember a card game when I need one so this post is in no way altruistic; it is a list that I know I will use myself. Adapt each games as you need to, if you have the luxury of an extra person encourage them to assist the player with dementia as much or as little as is necessary. Sometimes all that is required is a gentle but regular reminder of the rules or to keep an eye on whose turn it is.

Snap

Of course the most simple and well known game. You can play this with 2-multiple players. The dealer deals the entire pack of cards out face down between all the players. Then, starting with the player to the left of the dealer, and in turn, each person lays down the top card from their pile into a new pile (the discard pile) in the centre of the table. If the card being laid matches the card laid down by the previous player all players must say "Snap". The first person to say "snap" wins all the cards in the discard pile and play starts again. The winner is the player who collects all the cards.

Go Fish

The dealer deals all the cards. If there are two or three players, each player is dealt seven cards. If there are more people taking part, each player is dealt five cards. The remaining cards are placed face down in a pile. This is the “fish pond.”

Each player sorts their cards into groups of the same number or suit (i.e. group of threes or group of kings), making sure not to show anyone. The person to the left of the dealer starts the game by asking any another player for cards that will match his hand. For example, if they have two threes, she will ask the other player for threes. If the other player has these cards, he must hand them over. The same person continues asking the same player for more cards until the player does not have the cards he wants. If the player does not have the right cards, he can tell the requester to “Go fish.” The requester then has to take one card from the “fish pond.” The player who told him to “Go fish” becomes the new requester.

Anyone who collects all four cards of a set (i.e. all four eights or all four Queens) puts them face down in front of him. The winner is the first person to have no single cards left, only complete sets. If two people run out of cards together, the player with the most sets wins the game.

War

This is a two player game. All cards are dealt to the two players and kept face down. Neither player must look at their cards. Both players turn over the top card of their piles and put them face up in the centre of the table, beside the other player’s card. Whoever has turned over the highest ranking card takes both cards and adds them to the bottom of his pile. This continues until two cards of the same value (i.e. two sevens) are put down together. The game is now in a state of “war.” To continue, both players take two new cards and put one face down on top of the card they have already placed in the middle and one face up. Whoever puts down the higher ranking face up card wins all six. The game is won by the player who collects all of the cards.

Beggar my Neighbour

Deal out all the cards between the two players.

Each player takes it in turns to turn one over from the top of their pile and put it on the table between them (as with snap!) If you turn over a Jack, Queen, King or Ace, the other player must put down more cards as follows:

Jack - one card Queen - two cards King - three cards Ace - four cards

If no picture cards are turned over whilst this "payment" is being made, you collect all the cards from the table and put them at the bottom of your pile. However, if a picture card WAS turned over, your opponent immediately stops their 'pay out' of cards, and YOU have to pay them by putting down one, two, three or four cards, according to the rank, as above.

The winner is the player who collects all the cards.

I would recommend printing / writing out the "payments" as a visual reminder during the game.

Pelmenism / Concentration / Match

Maybe not a card game in the truest sense of the word but even so, one worth mentioning. There are some nice, adult themed match games on the market, or if you are feeling creative you could make your own.

You place all the cards face down on the table and each playing takes a turn to turn over two cards. If they match the player keeps the matching pair. If the cards don't match the player must place the cards back down on the table in the same place. The aim of the game is to remember which cards your opponents turn over and where they are so that you can match pairs when it is your turn to play.

This game can be adapted to the short term memory impairment of the people playing by reducing the number of cards you use.

Is the ubiquitous Christmas Gift List useful? Let's face it; not every lady would make use of a Cath Kidson gardening set, want the latest Peter Andre CD or get excited to open a 'top of the range' smoothie maker on Christmas morning. However I still find myself drawn to the 'list' and indeed am now embarking on writing my own!

It therefore goes without saying that not everything on this list will suit everyone living with dementia. Circumstances, personal taste, budget, stage of dementia and so on will dictate your final choice of present. I know from experience that some find it tricky to come up with an idea for their loved one, especially an older person, someone living in residential care or especially someone living with dementia so here are a few of my ideas ....

£10 and under

Colouring book - It is now easy to find an adult themed colouring book thanks to the latest trend. Combine this with a pack of coloured pens or pencils.

Bird feeder - Does your loved one look out of a window from their armchair or bed? A bird feeder attracts regular friends and topping it up is a great activity.

MP3 players - can be purchased for as little as £5. Load up an SD memory card with a selection of their favourite tunes.

Memory Box - Take a look at my post on memory boxes. If you have some time to put one together it would make a wonderful personal gift.

Hand lotion - Hand massages or even just to keep hands soft. Choose something with a familiar smell and a little luxury.

Photo frame - Fill a table top or hanging frame with family photos. Choose a simple frame so that it doesn't distract from the photo inside.

£10-£20

Jigsaw - There are some lovely adult themes jigsaws available that have a limited number of large pieces. At £15 they are, as you would hope, good quality and will stand repeated use.

A photo album - Put together a small album of family photographs, each one clearly annotated with names / location etc

Hanging Mobile- For someone who spends their days in their bed the view can sometimes be a little monotonous. A well placed and well chosen mobile can be a lovely distraction. (Be aware that this might not be suitable for someone who experiences visual delusions or visual confusion).

£20-£50

Fiddle cushion / apron / muff - These are readily available and ideal for someone at the latter stages of dementia who enjoy sensory stimulation. If you, or someone you know, is handy with a sewing machine it is a nice sewing project.

Aromatherapy diffuser - Well chosen aromatherapy oils can help to lighten the mood, calm a distressed individual and even stimulate appetite. Aromatherapy diffusers are heatless, flameless and smokeless so ideal where safety is of concern.

Bubble tube - At the later stages of dementia, when sensory stimulation is helpful a bubble tube can be a soothing and stimulating addition. They are available in a large range of sizes and price; the lower end of the price range are perfectly adequate.

Indoor plants - Looking after an indoor plant is a regular meaningful activity. You can choose a plant that suits the room (amount of sun etc) and the amount of care it might receive (i.e.. a cactus almost never needs water!).

Perfume / after shave - If your loved one has always worn perfume or after-shave it is nice to maintain that self care regimen.

A day out - Buying someone an experience as a gift is ideal for someone who 'has everything'. If it is practical to do so why not buy your loved one a voucher for afternoon tea and make it a day out.

£50 and over

Flowers - A monthly delivery of fresh flowers would brighten up any bedroom and arranging them provides a valuable, meaningful activity. At £15 a month it is a more substantial gift but one that will keep giving!

Small fridge - If you have a larger budget; for someone living in residential care there is something quite liberating about having access to you own supply of cold drinks in your own room.

A 5 hour train journey home from York is a rare piece of thinking time to digest the course I have been on today - Montessori based dementia programming, and to consider how it might impact on my day to day work.

There were 9 people on the course; a selection on Occupational Therapists, Physiotherapists ... and me! I am quite sure that those professionals, everyone of them passionate about improving the lives of people living with dementia will have their own opinion of the methods we learnt about today. There is much about it that leaves me cold not least of which is the name. Montessori is so closely associated with the education of children, and dementia 'programming' sounds very rigid and impersonal. The creator of the techniques, Cameron Camp speaks passionately about how the word Alzheimers Disease has a negative impact and that it should be renamed Alzheimers Syndrome so he understands the power of words, and yet there is no acknowledgement of the impact of using the terms 'Montessori' or 'Programming'. I am sure that if nothing else the name will stop this menthod from becoming more widely used.

What is Montessori

The Montessori method shares some underpinning principles with other dementia approaches such as the Eden Alternative; the importance of meaningful activity that is person centred, and that a diagnosis of dementia should not be a signal to disengage, disempower or disenfranchise that individual. The practical application of Montessori seems more confusing. It is a mixture of implementing everyday living activities such as laying the dinner table and more therapeutic interventions like moving beans from one bowl to another. It is these latter activities which are more controversial. They are based on the first in / last out theory that skills we learnt first as a child are the last to go.

When it works

In my opinion it is the later stages of dementia that the therapeutic approach of Montessori comes into its own. The facilitator is encouraged to consider environment, demonstrate before expecting participation, start at a basic level before increasing difficulty, and to use minimal communication to avoid confusion. Tasks are straightforward and use everyday objects that are pleasing to the eye. All good so far. The concerns many people have with Montessori is the types of tasks suggested. They seem to rarely have purpose, they could be construed as childish and patronising.

I have tried some of these tasks, for example sock matching and putting pegs on a box, and I think this approach has a place; with an individual who is disengaging, is lost in the world around them, who finds every day activities challenging, confusing and distressing. The simplistic tasks can be really successful at providing someone with the occupation and achievement otherwise lost to them.

A word of caution

If possible try to retain some form of purpose. If you want to try shoe polishing find shoes that actually need polishing. If the task is to fold towels get freshly dried ones from the line or tumble drier. In other words, activity should be a spontaneous reaction to the environment around you rather than prescribed tasks pulled out of drawer. This is where Montessori and I part ways! Taking a pile of freshly folded napkins from the linen cupboard, shaking them out and giving them to someone to fold again undermines everything we are trying to change about dementia care..... and one day one of those people you are handing them to will catch you out and you will realise how wrong it is. I've been there.

PostScript

Something I learnt from my fellow students today was how difficult it can be to be spontaneous and instinctive about activities in some medical settings, and yet how much staff want to stimulate and enthuse their clients with dementia. Life on an acute medical ward, or even a rehabilitation unit is dictated by health & safety, budget and even space. Many of the ideas I have spring from my work in residential homes and what I hope is possible in people's own homes. The determination of staff in these roles is inspiring and I will try to consider some adaptations to my weekly blogs to inspire these lovely people too!

I am not a wordsmith so I shy away from writing lengthy blog posts and prefer to show you something instead. However this week I do want to share with you some of my recent experiences of community engagement with residential care.

When I started my new job just a couple of months ago one of the initial aims I set for myself was to initiate regular and significant community engagement. I firmly believe that bringing people into a care home, and supporting those living in residential care to spend time in their local community has numerous benefits for everyone involved.

Local coffee mornings

Our local Alzheimer Scotland group has started a Musical Memories coffee morning once a month. It takes place in the local church hall and we had a duet from the Music in Hospitals organisation singing to us, as well as a tea and cake break midway through. A lady and gentleman who live where I work came with me last month. He took huge pleasure from singing and clapping along and she smiled almost the entire afternoon. During the 'interval' ladies from the church came and sat with us and chatted to my friends about local people and places they knew. There were awkward moments when the hosts would insist on using the phrase "do you remember" far too often, and asking me "do they take sugar" but, and here is the first lesson, they will learn. Me and my two friends started the dementia education of these kind, well intentioned ladies and my friends had an absolute ball in the process.

Halloween Trick or Treat

We are a small residential home so a handful of visitors in our main lounge instantly feels like a party. On Halloween we were visited by over a dozen children; staff family, friends and supporters. In advance the residents and I had prepared treat bags and party games and decorated the lounge. On the night each child performed to earn their treat bag; the ladies charmed by toddlers singing their songs, the gentlemen amused by silly jokes. It felt joyous, for everyone involved. The photo of one the older ladies in our home, beaming from ear to ear, with a 1 year old 'pink rabbit' on her lap for a cuddle will endure in my memory for some time to come and inspire me to continue to organise such events. Both the children and those living in the home benefited from our Halloween night; the children genuinely had fun and engaged with people in their community who need them for their engagement, support and love. The adults genuinely had fun and engaged with people in their community (two of whom are wheelchair users with significant needs) who need them for their learning, development, support and love. It's a win:win.

Swimming

Two of the people I work with had expressed an interest in going swimming. So far I have taken one gentleman to the pool. It was a challenge of access, practicalities, confidence and timing but it paid off as we encountered helpful staff, warm water and, amazingly, an empty pool. My friend achieved significant exercise as well as periods of floating relaxation and I boosted my confidence and enthusiasm to continue to be brave and empower the people I work with to be brave too.

In addition we have also been to the garden centre, library, local shops. We have had a bake sale and are planning a fireworks party, Christmas Fair and Christmas decorating party as well a a trip to the local AmDram panto. I plan to organise for volunteers to help us in the home and, if I can, for one or two of the residents to volunteer in the community themselves. It's a big task but it is hugely rewarding for everyone involved. I'm not pretending I am the only person doing this; I know for sure that there is amazing work happening in residential care across the country, but for those who aren't I hope this will give you some inspiration and / or confidence to try and engage with your community.

Reminiscence is a well-known and well used activity if you are working with people living with dementia. Sometimes the challenge can be finding a fresh and inclusive way to approach it. If you are looking for a presentation to a group that will appeal to a larger audience as well as an activity that you can use on a 1:1 basis then ‘On this day’ is something for you to consider.

‘On this day’ isn’t a new idea. You take a specific date and research what happened on that day throughout history. You aren’t tied to a specific period in history either, so you can adapt for your audience, and you can use a multi-sensory approach. Have some fun with it!

Some research is required to build up the information you need but with the wonders of the internet it is pretty straightforward and quick to do.

As an example I have looked at the date today, when I am writing this blog; 18th September.

My first destination is www.bbc.co.uk/onthisday a BBC website showing you the top news of the day going back to 1950. I have learnt that;

In 1970 Jimmy Hendrix died. So, I’ll find some film of Jimmy Hendrix from YouTube.

The FBI captures Patty Hearst. I will then find some information about Patty Hearst so I can read out a short paragraph about her.

In 1830 the "Tom Thumb", the first locomotive built in America, raced a horse on a nine-mile course. I have found photographs through Google so will print one off and make sure I have some information to talk about it a little.

In 1809 The Royal Opera House opened. If I have access to a laptop or tablet I could find some opera performances from the Royal Opera House to share.

In 1879 the famous illuminations in Blackpool were switched on for the first time. I could print off a photo and / or get some fairy lights for a fully sensory experience allowing you to involve someone with end-stage dementia.

In 1995 A Carlisle motorist was fined £140 for throwing a doughnut at a traffic warden. OK so this is pushing the envelope a little bit but you could get some donuts, cut them up so everyone gets a piece and have a jovial chat about traffic wardens!

From just 4 websites I now have hearing, vision, taste and touch stimulated by photos, film, music, a historical story, food and lights which can easily be passed around a group or shared with an individual. If you get caught up with the first item which leads into a long discussion then so be it but you’ll also have a good selection of great conversation starters to work your way through.

A few months ago I started following the blog of an inspirational lady. Kate Swaffer is, amongst many other things, an "advocate and activist for aged and dementia care". She also happens to be living with the disease.

As the parent of a child with a disability I have often gone to great lengths to make sure that professionals understand that I am the expert on my son; I advocate for him and know him better than they ever will. So it isn't rocket science to understand that this is no different from anyone else with a disability; they or their advocates know them best.

I work with/for people living with dementia and I believe that to do my best for the people I work with I need to listen to them, and others who have the disease. So when I read Kate blog entry 'Please, don't send me to Day Care" yesterday, it struck me to the core and I felt it was so important that I share it with everyone I know who works, or spends time with people living with dementia. With Kate's permission I copy it here;

If you search in googleimages.com for an image to match the term ‘Day Care’ you mostly only find images for children day care services and centres, as per this image I have added today! I wrote the following for a friend and colleague, to read out at a conference who is attending soon with an audience of life style and activity co-ordinators.

“Let me begin with the word ‘day’ used in ‘day’ respite.

Many people with dementia, who are over the age of about 5 or 6, feel the use of the word ‘day’ program, ‘day’ respite, or ‘day’ activity centre, is little different to the use of the term ‘day’ care that we took our pre school children to.

It is, in itself, infantilising us before we even get there, and many with dementia would simply refuse to go to any respite program with the use of the word ‘day’ in it.

Let me finish with a few words about what happens in these well meaning ‘day programs, and how offensive some of the things that happen there,that I and many others with dementia find them to be. Using ‘gold stars’ for winning some make believe event, or plastic ‘gold medals’ for the best piece of ‘art work’. Often, people with dementia are almost forced into these programs, to give their care partners a much needed break, but, the activities need to be age appropriate, and truly engaging and individually meaningful. By that, I mean meaningful to us, and with some inherent value to our lives and existence, not easy for you or of interest to the lifestyle coordinator.

Activities need to also have some inherent value in them, value to our lives, things that make us want to get out of bed, not just fill in the time and the boredom of being there. Real activities, like going out into our community and being supported to volunteer or joining a sporting club, a gardening club, or even a social group outside of the place of respite. Activities like singing, music and dancing, but only if we like those activities. Some of us might prefer to be in a book club. This is also, after all, part of being I our community, and part of our community being dementia friendly.

Please think about our needs, stop the use of words, terms and activities that feel to us like child care, and finally, ask yourself if what you are offering is gender and age appropriate, as well as individualised to ensure it is person centred.”

Working myself in residential care I can only hope that not all Day Care centres are as Kate fears, I do know though that many residential homes are. If you work in this field or spend time with someone who has dementia please think and think again when you plan activities. Read and re-read Kate's advice, she knows, she's living it.

It is the half-term school holiday this week in Scotland so writing this week's post has been a challenge of time management. As we are having a fundraising Bake Sale at work this week I also have cooking to do, so I have tied this blog and baking together and am showing you how to make chocolate covered marshmallows. Time will tell if they are a good seller at a Bake Sale but they are definitely pretty easy to make, look good and I'm sure your grandchildren / children / Halloween trick or treaters will bite your hand off for them.

This is a perfect activity to do with a full range of abilities. There are plenty of different aspects to the task for members of a group to be involved or for a couple to share. Melted chocolate should never get hot (or you have ruined it!) so working with chocolate is also a safe activity.

You need:

Marshmallows (a 200g bag made 10 chocolate sticks)

250g Chocolate (I used milk chocolate chips, you can also use bars of chocolate broken into pieces)

A variety of cake sprinkles

Bamboo skewers

Greaseproof paper or a non-stick baking sheet

Method:

Thread 3 marshmallows onto a skewer. The skewers are quite long so I broke off the end I had threaded them over as it becomes quite sticky.

Melt the chocolate. If you melt chocolate properly (tempering) you will get a shiny smooth result. Luckily there is an easy way to temper chocolate using either a microwave or a bowl over simmering water (bain marie). Put all your chocolate in a bowl (remembering to break bars into small pieces). Melt very gently; over simmering water or 30secs at a time in the microwave, stirring regularly. Once half the chocolate is melted (as my photo below) remove the chocolate from the heat / microwave and continue stirring until all the chocolate has melted. This can take a few minutes. You should end up with smooth runny chocolate. If the chocolate is still too think to run off the spoon heat VERY gently again for just 30 seconds and stir again

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You can now start to cover your marshmallows in chocolate. I found this easiest to do by holding the skewer over the bowl of chocolate and spooning the chocolate over the marshmallows. Once they are completely covered you now need to let all the excess drip away. I helped this along by scooping some off the underneath of the marshmallows as they dripped.

Then cover your chocolate with sprinkles. Again, I did this by holding the marshmallows over the bowl of sprinkles and shaking them over and / or using my hands to sprinkle. If you haven't removed the excess chocolate you will find it drips into your sprinkles bowl and you are then in a mess! The only unsuitable sprinkles I discovered were the heavier 'smarties type' which slid off the chocolate.

Place your finished marshmallows on a piece of greaseproof paper or non-stick sheet to harden; it only takes about 10 minutes.

You can then either serve / give them away as they are or wrap them up and add a bow!!

If you have any left-over chocolate pour it onto another piece of greaseproof paper, add sprinkles and let it harden into a giant chocolate button.

I hope you will have a go at making these. If you are planning them as a Halloween treat many of the high street shops have Halloween themed sprinkles, or you could make them nearer Christmas with festive decoration.